Provider Demographics
NPI:1740817337
Name:MELANCON, COREY ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:ALLEN
Last Name:MELANCON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-374-1410
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:8300 CONSTANTIN BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3489
Practice Address - Country:US
Practice Address - Phone:225-374-1410
Practice Address - Fax:225-374-1616
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2023-08-01
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Provider Licenses
StateLicense IDTaxonomies
LA331150207PP0204X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine